Treatment, management, and handling of individuals handicapped by reason of neorological or muscular impairment presents a range of problems extending from the elementary such as merely lifting one's head to the very complex such as the locomotor coordination necessary to feed or draw. Many forms of trauma effect human growth and development and cause disadvantage in bodily functions that make ordinary achievement difficult, if not impossible. Mental retardation, cerebral palsy, muscular dystrophy and brain damage are examples of the traumas which cause the handicap. All of these are characterized by an increased need for postural support in order to prevent advancement of the handicap and the development of resulting degenerative conditions such as spastic extension, deformation of extremities, improper posture development, respiratory impairment, scoliosis and the like.
Many handicapped individuals can be rehabilitated and helped to achieve a degree of self reliance through the use of properly designed supportive apparatus which support the body in the most normal posture possible without undue restraint. One of the largest group of handicapped who can benefit of proper supportive device are those suffering from cerebral palsy and this condition is selected for illustrative description in connection with the instant invention.
The term cerebral palsy includes all of those disorders of the central nervous system resulting from brain damage and characterized by spastic paralysis and impaired motor abilities. It is known that of the large number of cerebral palsy victims, a great majority are infants and young adults. It is also known that of the large number of cerebral palsy victims, a great majority are infants and young adults. It is also known that with proper care and rehabilitative training through physical therapy, persons handicapped by cerebral palsy can be physically improved, often to a degree such that they become largely self-sufficient. Early treatment and rehabilitation is particularly important to the physical and mental development of cerebral palsy victims. In general, the treatment of cerebral palsy involves the use of various types of therapeutic or rehabilitative equipment for the purpose of preventing the development of deformities caused by muscular inadequacy and to enhance the physical development of the patients. Presently available equipment, particularly in the support and locomotion areas, is generally inadequate to satisfy the therapeutic requirements with respect to support of the patient and prevention of the development of deformities. In general, such support is essential in order to correct, as far as possible, existing postural abnormalities and also to prevent continual deterioration of bodily functions as a result of the abnormality. In many instances, the use of proper supportive apparatus can prevent the development of permanent disability or deformity caused by but not directly associated with the muscular or neurological disability itself. For example, respiratory insufficiency or joint dislocation is often the result of an uncorrected postural abnormality which itself may be partially due to inadequate environmental support. Since the range of physical impairment is so wide and the number of associated handicaps so extensive, e.g., vision, hearing, speech, intelligence and emotional levels, supportive equipment for handling and management of such persons must be either custom made or exceptionally versatile.
In the past, the approach most commonly used was to attempt to adapt available equipment such as wheel chairs, walkers, cribs and the like, to the individual needs of the subject. In many cases, this approach actually was nothing more than merely conforming the subject's needs to available equipment.
The need for a therapeutic and supportive device capable of meeting individual postural needs is manifest.
A rehabilitative apparatus of this type serves in a variety of capacities for the purpose of overcoming the lack of muscular ability and resulting deformity. The apparatus should be capable of assisting in the development of postures which approach normal postures and in the development of motor patterns which strengthen a limited range of movement of cerebral palsy victims. The development of useful motor skills is particularly important. By assisting in the development of motor abilities, it is often possible to enable even more severly handicapped patients to develop means of self-expression, independence and in feeding, dressing, and other necessary functions. Through the use of properly designed equipment, it is possible for patients to carry on in the absence of a physical therapist.
A chair or similar apparatus is one of the more common devices used in the treatment and rehabilitation of cerebral palsy victims. Through the use of a correctly designed and adjusted chair which fits the patient, nearly normal head, neck and sitting postures and a wide range of muscular and vocational activity of a therapeutic nature can be achieved. Through the use of suitable accessory equipment, the patient can be exposed to and participate in a variety of manual experiences. When provided with wheels, the patient can be moved from location to location without lifting and carrying. When securely seated in a chair, a patient can amuse himself for long periods of time and thereby develop manipulative skills without reliance upon outside help.
A complete and useful therapeutic chair or vehicle should include back and buttock support means which can be positioned to permit comfortable placement of a somewhat abnormal physical structure. In addition, it is desirable that the chair include a support platform on which the patient's feet may rest. Such a platform should be positioned so that the patient can sit comfortably on the chair with his thighs resting on the seat and the soles of the feet resting flat on the footrest.
In addition, the apparatus should be provided with a table or work surface which fits securely around the patient when seated in the chair or when standing so that manual skills can be encouraged. Such a table should be adjustable to accommodate developing skills and physical growth, and removable to facilitate entry and egress from the chair. Because of the long term aspect of the disease and rehabilitation, the apparatus must be designed for a wide range of adjustments in order to accommodate developing skills and physical growth. Independent adjustability of the various mechanical aspects of the device is particularly important in view of the often abnormal growth patterns characterized by the cerebral palsied.
An object of this invention is to provide an efficient and sturdy vehicle for providing mobility and support for invalids, particularly those having the neurological and muscular dysfunctions which are characteristic of those afflicted with cerebral palsy.
Another object of the invention is to provide a vehicle of the type described, having body supporting features such as seat, back support, foot rest, and activity tray, all of which can be independently adjusted in both horizontal and vertical planes.
Another object of the invention is to provide a postural support apparatus for the correction and treatment of postural abnormalities.
Another object of the invention is to provide a therapeutic device or apparatus for support of the human body in a manner sufficient to prevent development or worsening of postural abnormalities.
A further object of the invention is to provide a wheeled chair capable of providing mobility and body support as well as activity promoting means such as an adjustable work or play table or tray.
Still another object is to provide a vehicle of the type described which provides a safe and convenient place for a person of limited motor and muscular ability.
These and other related objects are provided by a wheeled chair or carriage having an integral frame upon and within which there is provided a seat, back rest, and activity table, together with means for independently adjusting the relative positions of each of the aforementioned members to accommodate individual size and disability characteristics.